2009 OPEN FORUM Abstracts
EVALUATION OF THE RESPIRONICS BIPAP® AUTO SV AND RESMED VPAP ADAPT SV TO LUNG SIMULATOR GENERATED CENTRAL AND OBSTRUCTIVE SLEEP APNEIC EPISODES
Grant Drake, Dawn M. Alverson, Jody Lester; Respiratory Care, Boise State University, Boise, ID
Background: Recent developments in non-invasive positive pressure ventilation have led to the production of adaptive servo-ventilation devices that examine an individual’s breathing characteristics and adjust pressure levels via a product specific algorithm. We evaluated two adaptive servo-ventilation devices, the Respironics BiPAP® auto SV and ResMed VPAP Adapt SV to lung simulator generated central and obstructive sleep apneic episodes. Methods: Each system was adjusted to the following settings: EPAP minimum 4 cmH2O, IPAP maximum 15 cmH2O, adaptive modes, 15 breaths per minute. Each system was tested using its own brand of ventilation circuit and face mask (Respironics Comfort Gel Full and Mirage Quattro). The masks were fitted to a Laerdal SimMan® version 2 mannequin and demonstrated minimal leak levels. The SimMan® was connected to a Hans Rudolph Electronic Breathing Simulator (HR 1101) which generated 15 normal breaths followed by central and obstructive apenic episodes. The lung simulator scripts were constructed with the following parameters: compliance 40 cmH2O, amplitude 20 cmH2O, resistance ramped from 5 to 200 L/sec during obstructive apnea simulation and compliance 40, amplitude 0 and resistance of 50 during central apnea simulation. Results: During simulated obstructive apnea the VPAP Adapt SV delivered an average pressure of 7.53 cmH2O and an average Vt of 299.7 ml. Max/Min pressures were 11.148 cmH2O and 5.104 cmH2O. The BiPAP® auto SV delivered an average pressure of 6.41 cmH2O with an average delivered Vt of 257.2 ml. Max/min pressures were 11.8 cmH2O and 3.18 cmH2O. During simulated central apnea the VPAP Adapt SV delivered an average pressure of 8.95 cmH2O and an average Vt of 354.4 ml. Max/min pressures were 14.5 cmH2O and 5.08 cmH2O . The BiPAP® auto SV delivered an average pressure of 7.04 cmH2O and average Vt of 280.06 ml. Max/Min pressures were 11.81 cmH2O and 3.22 cmH2O. Conclusion: Each system responded adequately to both types of apnea however, some differences were recognized. The VPAP Adapt SV has more clinician definable parameters and our obeservations were that it performed better in tests simulating central apenic episodes. We observed that the BiPAP® auto SV performed better during obstructive apenic episodes.Initially the BiPAP® auto SV demonstrated a long rise time and delivered smaller volumes when respiratory rate was set on “auto”; using a set rate of 15 alleviated this discrepancy. Sponsored Research - None